Reframing prolonged negative mental health effects of COVID-19: Cognitive restructuring promotes posttraumatic growth

The study aimed to investigate the level of peritraumatic distress in relation to possible traumatic outcomes in university personnel and students across three pandemic waves. Three cross-sectional surveys were conducted to investigate university students and staff (n = 1426). An online survey including the COVID-19 Peritraumatic Distress Index (CPDI), Ways of Coping, Impact of Events Scale (IES), and Posttraumatic Growth Inventory (PTGI) were administered across three waves. Psychometric properties of the Hungarian version of CPDI were assessed and associations between peri/posttraumatic stress and coping were explored. Cluster analysis based on posttraumatic stress and growth was used to identify subgroups. An increasing trend of peritraumatic stress over the waves was found. Regression analyses revealed that two coping styles, cognitive restructuring and problem analysis were negatively and positively associated, respectively, with both peritraumatic and posttraumatic stress. Two-step cluster analysis conducted on PTGI and IES scores yielded three clusters of posttraumatic changes: IES-low/PTGI-low, IES-high/PTGI-low and IES moderate/PTGI-high. Multinomial regression showed that cognitive restructuring and peritraumatic stress were significant predictors of cluster membership. Our findings point out that cognitive restructuring may be effective for dealing with longer-term psychological results of traumatic life events, such as the COVID-19 pandemic, even in highly exposed groups of the society

Medical students and staff (n=1426) were recruited for the study. An online survey including the COVID-19 Peritraumatic Distress Index (CPDI), Ways of Coping, Impact of Events Scale (IES), and Posttraumatic Growth Inventory (PTGI) and other questionnaires were administered across three waves of COVID-19. Psychometric properties of the Hungarian version of CPDI were assessed and associations between peri/posttraumatic stress and coping were explored. In addition, cluster analysis based on posttraumatic stress and growth was used to identify subgroups.

An increasing trend of peritraumatic stress over the waves was found. Regression analyses revealed that two coping styles, cognitive restructuring and problem analysis were negatively and positively associated, respectively, with both peritraumatic and posttraumatic stress. Two-step cluster analysis conducted on PTGI and IES scores yielded three clusters of posttraumatic changes: IES-low/PTGI-low, IES-high/PTGI-low and IES moderate/PTGI-high. Multinomial regression showed that cognitive restructuring and peritraumatic stress were significant predictors of cluster membership.

Our findings point out that cognitive restructuring may be effective and suitable for dealing with longer-term psychological results of traumatic life events, such as the COVID-19 pandemic, even in highly exposed groups of the society.

本研究旨在探究大学员工与学生在三次疫情浪潮中遭受的围术期心理创伤应激水平与其可能的创伤后果之间的关系。研究通过三次横断面调查对1426名大学生和教职工进行了调查。在线调查包括COVID-19围术期心理创伤应激指数（CPDI）、应对方式、事件影响量表（IES）以及创伤后成长量表（PTGI）等。对CPDI的匈牙利语版本进行了心理测量学评估，并探讨了围术期/术后应激与应对方式之间的关联。基于术后应激与成长进行的聚类分析被用于识别亚组。研究发现，随着浪潮的推移，围术期应激呈现出上升趋势。回归分析显示，两种应对方式——认知重构和问题分析——分别与围术期和术后应激呈负相关和正相关。对PTGI和IES得分进行的两步聚类分析得出了三个创伤后变化簇：IES低/PTGI低、IES高/PTGI低以及IES中等/PTGI高。多项回归分析表明，认知重构和围术期应激是簇成员身份的重要预测指标。我们的研究结果指出，认知重构可能对于处理创伤性生活事件（如COVID-19大流行）的长期心理后果具有有效性和适用性，即便是在社会高暴露群体中也是如此。